Frailty status, inflammatory, and muscle catabolism biomarker patterns: a strong association?

Fraily development is largely determined by low levels of nutrients, increased expression of inflammatory biomarkers, and age-related oxidative stress (OS). These frailty-related dysfunctions may lead to impairments in muscle structure and function, causing the onset of a muscle-catabolic state. As such, they may contribute to the development of sarcopenia, which is both a cause and a consequence of frailty. Measuring biomarker patterns such as dietary, OS, inflammatory, and muscle-related biomarkers (e.g., 3-methylhistidine (3MH)) has been touted as a means to understand the complex mechanisms behind frailty. Despite this, data on multi-biomarker patterns remains scarce. The aim of this study was to measure a variety of circulating biomarkers in an attempt to characterise their patterns. The existence of an association between these patterns and frailty status in non-frail and frail in-hospital patients was then assessed.

Predicting and acknowledging the role of resilience in elderly patients

Resilience is characterised by the ability to bounce back after exposure to a stressor or a form of adversity. It is frequently separated into physical and psychological components, with the former being defined as the ability to recover following age-related losses or disease. A decline in resilience is both a marker and a risk factor for accelerated ageing and frailty, respectively. The aim of this editorial was to showcase the importance of resilience in the recovery of frail patients. It also exposes the mechanisms behind resilience, as well as the gaps in its clinical assessment.

Frailty: a predictor of mortality, hospital readmission, and length of stay?

The Hospital Frailty Risk Score (HFRS) was developed to detect frail individuals based on data extracted from hospital databases. An association between the HFRS, 30-day mortality, 30-day emergency hospital readmission, and long length of stay (LOS) was originally validated in populations of elderly patients admitted to hospital via the emergency department. Data regarding the HFRS’ predictive ability in the context of direct admissions and post-discharge outcomes is thus lacking. The aim of this study was to investigate the associations between the HFRS and 30-day mortality, 30-day hospital readmission, and long LOS by analysing in- and out-patient healthcare in France.

Frailty: a growing concern in the UK

Frailty is characterised by increased vulnerability to acute stressors associated with an age-related decline in function across multiple physiological systems. Since it is an age-dependent clinical syndrome, countries with ageing populations, like the United Kingdom (UK), are predicted to become increasingly exposed to worsening frailty-associated patient outcomes and burdened healthcare systems. This article aimed to emphasise the importance of frailty-related education for healthcare professionals in the UK.

Frailty instruments in patients with heart failure: a comparison of predictive performance

Frailty is characterised by increased vulnerability to acute stressors. As it is common in adults with heart failure (HF), frailty has been used as a predictor of mortality and morbidity for HF patients. Frailty Phenotype, the most commonly used frailty instrument in HF, is used for the physical examination of frailty. While physical frailty instruments are commonly used in clinical practice, a proportion of studies have expressed issues with such tools. As HF may have detrimental effects on physical function, the use of physical instruments may lead to an under- or over-estimation of frailty. This study aims to compare the predictive ability of three physical frailty instruments (the Frailty Phenotype, the St Vincent’s Frailty instrument and the SHARE-FI); and three multi-domain instruments (the FRAIL scale, the Deficit Accumulation Index, and St Vincent’s Frailty plus cognition 7 and mood) in adults with HF.

Clinical Frailty Scale and Frailty Index in Predicting Long-Term Survival for the Critically Ill: a review

Frailty is a state of vulnerability, recognised clinically, where patients experience an ageing-associated decline in their physical and cognitive abilities. There are two main scales for measuring frailty. The Clinical Frailty Scale (CFS) is often used for intensive care unit patients. The Diseases-10 Modified Frailty Index (mFI) is also used; it is derived from the understanding of 11 comorbidities. However, it was unknown how the two compare. In this study of 7,001 patients, it was found that a greater proportion of patients were categorised as frail using the CFS, and this scale also predicted better those who would survive past the 6-month mark versus those who would die. This indicates that the two scales are not equivalent, and the mFI should not be used for frailty. This review by A. Subramaniam et al. aimed to highlight the differences between the two scales, the Clinical Frailty Scale and the Diseases-10 Modified Frailty Index, to determine which is a better predictor of frailty.
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